Epstein barr virus hemophagocytic lymphohistiocytosis related to rituximab use and immunopathogenetic insights

Anti-CD20-based chemo-immunotherapeutic regimens have been suggested to assist in the management of Epstein-Barr virus (EBV)-induced hemophagocytic lymphohistiocytosis (HLH) and EBV-associated post-transplant lymphoproliferative disorders (EBV-PTLD), by reducing EBV viral load and EBV-induced inflam...

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Veröffentlicht in:	Pathology, research and practice research and practice, 2016-12, Vol.212 (12), p.1194-1198
Hauptverfasser:	Papageorgiou, Sotirios G., Tsiodras, Sotirios, Siakallis, Georgios, Bazani, Efthimia, Spathis, Aris, Poulakou, Garyfalia, Korkolopoulou, Penelope, Panayiotides, Ioannis, Pappa, Vasiliki
Format:	Artikel
Sprache:	eng
Schlagworte:	Aged Anti-CD 20 Antineoplastic Agents - adverse effects EBV Epstein barr virus Epstein-Barr Virus Infections - drug therapy Epstein-Barr Virus Infections - pathology Hemophagocytic lymphohistiocytosis Hodgkin Disease - drug therapy Hodgkin Disease - pathology Hodgkin lymphoma Humans Leukemia, Lymphocytic, Chronic, B-Cell - drug therapy Leukemia, Lymphocytic, Chronic, B-Cell - pathology Lymphohistiocytosis, Hemophagocytic - complications Lymphohistiocytosis, Hemophagocytic - pathology Lymphohistiocytosis, Hemophagocytic - virology Male Neoplasms, Second Primary - drug therapy Neoplasms, Second Primary - pathology Richter’s Rituximab Rituximab - adverse effects Virus Activation
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Zusammenfassung:	Anti-CD20-based chemo-immunotherapeutic regimens have been suggested to assist in the management of Epstein-Barr virus (EBV)-induced hemophagocytic lymphohistiocytosis (HLH) and EBV-associated post-transplant lymphoproliferative disorders (EBV-PTLD), by reducing EBV viral load and EBV-induced inflammation. Herein we report a fatal EBV-related HLH in the context of Hodgkin lymphoma (HL)-like Richter’s transformation of B chronic lymphocytic leukemia (B-CLL), two months after rituximab treatment. The complex balance between EBV driven T-cell stimulation and immunosuppressive therapy in the context of multiple immune deficits is discussed.
ISSN:	0344-0338 1618-0631
DOI:	10.1016/j.prp.2016.10.003